Abby Michelle Roth

NPI #1134961758 in Glen Carbon, Illinois

Provider Information

NPI Number: 1134961758
Entity Type: Individual
Name: Abby Michelle Roth
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Enumeration Date: Jun 12, 2024
Last Updated: Jun 12, 2024

Practice Location

Address: 21 GLEN ED PROFESSIONAL PARK
City: Glen Carbon
State: Illinois
ZIP Code: 62034-3333
Phone: (618) 656-0608

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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